title: Inexperienced sonographers can successfully visualize and assess a three-dimensional image of the fetal face using a standardized ultrasound protocol.
abstract: BACKGROUND
  A standardized three-dimensional ultrasonographic (3DUS) protocol is described that allows fetal face reconstruction. Ability to identify cleft lip with 3DUS using this protocol was assessed by operators with minimal 3DUS experience.
  
  
  METHODS
  260 stored volumes of fetal face were analyzed using a standardized protocol by operators with different levels of competence in 3DUS. The outcomes studied were: (1) the performance of post-processing 3D face volumes for the detection of facial clefts; (2) the ability of a resident with minimal 3DUS experience to reconstruct the acquired facial volumes, and (3) the time needed to reconstruct each plane to allow proper diagnosis of a cleft.
  
  
  RESULTS
  The three orthogonal planes of the fetal face (axial, sagittal and coronal) were adequately reconstructed with similar performance when acquired by a maternal-fetal medicine specialist or by residents with minimal experience (72 vs. 76%, p = 0.629). The learning curve for manipulation of 3DUS volumes of the fetal face corresponds to 30 cases and is independent of the operator's level of experience.
  
  
  CONCLUSIONS
  The learning curve for the standardized protocol we describe is short, even for inexperienced sonographers. This technique might decrease the length of anatomy ultrasounds and improve the ability to visualize fetal face anomalies.
authors.affiliation: Departments of Gynecology and Obstetrics, University Hospital of Lausanne CHUV, Lausanne, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Guenot
authors.forename: D
authors.initials: D
authors.lastname: Baud
authors.forename: K
authors.initials: K
authors.lastname: Lepigeon
authors.forename: K
authors.initials: K
authors.lastname: Francini
authors.forename: M-C
authors.initials: MC
authors.lastname: Rossier
authors.forename: P
authors.initials: P
authors.lastname: Hohlfeld
authors.forename: Y
authors.initials: Y
authors.lastname: Vial
mesh_terms: D005145:Face / Q000002:abnormalities / Q000000981:diagnostic imaging*; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000706:statistics & numerical data; D019767:Maxillofacial Abnormalities / Q000000981:diagnostic imaging; D015588:Observer Variation; D012015:Reference Standards; D016216:Ultrasonography, Prenatal / Q000379:methods* / Q000706:statistics & numerical data